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Self-harm in England: a tale of three cities

Multicentre study of self-harm

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Abstract

Background

Self-harm is a major healthcare problem in the United Kingdom, but monitoring of hospital presentations has largely been done separately in single centres. Multicentre monitoring of self-harm has been established as a result of the National Suicide Prevention Strategy for England.

Method

Data on self-harm presentations to general hospitals in Oxford (one hospital), Manchester (three hospitals) and Leeds (two hospitals), collected through monitoring systems in each centre, were analysed for the 18-month period March 2000 to August 2001.

Results

The findings were based on 7344 persons who presented following 10,498 episodes of self-harm. Gender and age patterns were similar in the three centres, 57.0% of patients being female and two-thirds (62.9%) under 35 years of age. The largest numbers by age groups were 15–19 year-old females and 20–24 year-old males. The female to male ratio decreased with age. Rates of self-harm were higher in Manchester than Oxford or Leeds, in keeping with local suicide rates. The proportion of patients receiving a specialist psychosocial assessment varied between centres and was strongly associated with admission to the general hospital. Approximately 80% of self-harm involved self-poisoning. Overdoses of paracetamol, the most frequent method, were more common in younger age groups, antidepressants in middle age groups, and benzodiazepines and sedatives in older age groups. Alcohol was involved in more than half (54.9%) of assessed episodes. The most common time of presentation to hospital was between 10 pm and 2 am.

Conclusions

Multicentre monitoring of self-harm in England has demonstrated similar overall patterns of self-harm in Oxford, Manchester and Leeds, with some differences reflecting local suicide rates. Diurnal variation in time of presentation to hospital and the need for assessment of non-admitted patients have implications for service provision.

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Acknowledgements

The project was funded by the Department of Health. The authors from Oxford thank Elizabeth Bale and Anna Shepherd and members of the general hospital psychiatric services for their assistance with data collection. The authors from Manchester would like to thank the clinicians completing MaSH assessment forms and the research team for their data collection, Iain Donaldson, Maria Healey and Stella Dickson. The authors from Leeds thank colleagues in the Emergency Departments—the clinicians and, in particular, the clerical and administrative staff. The views expressed are solely those of the authors.

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Authors and Affiliations

  1. Centre for Suicide Research, University Dept. of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK

    Keith Hawton, Helen Bergen, Deborah Casey & Sue Simkin

  2. Centre for Suicide Prevention, Division of Psychiatry, University of Manchester, Manchester, UK

    Ben Palmer, Jayne Cooper & Nav Kapur

  3. Academic Unit of Psychiatry and Behavioural Sciences, School of Medicine, University of Leeds, Leeds, UK

    Judith Horrocks, Allan House, Rachael Lilley, Rachael Noble & David Owens

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  1. Keith Hawton
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Correspondence to Keith Hawton.

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Hawton, K., Bergen, H., Casey, D. et al. Self-harm in England: a tale of three cities. Soc Psychiat Epidemiol 42, 513–521 (2007). https://doi.org/10.1007/s00127-007-0199-7

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